Is Brava Necessary for Fat Transfer to Breast?

Question

Is the Brava system really necessary for a successful fat transfer to the breast? It's pretty expensive and the procedure itself is expensive already. Also, can fat be saved or frozen for a second and third round session for fg to breast instead of getting lipo again?

Sarah Mess, MD · Answer

The Brava Bra is not required for fat transfer results. I have experience with the Brava Bra but no longer offer it as an option. Patients can achieve excellent results without the use of external expanders.

Larry S. Nichter, MD, MS, FACS · Answer

No BRAVA is not necessary but if there is minimal fat donor sites and minimal breast tissue to start with, it is probably is helpful as there is probably increased take, according at least with the early studies thus far. If you have enough fat to transfer however then over time and with perhaps with an addtional fat transfer procedure (vs the hassle and expense of the BRAVA devise) you would probably end up with the same outcome. There is a limited amount of fat that I typically inject depending on the siae of the breast you are starting with is in my hands 200-350+ cc per session without Brava. Most but not all of the fat survives as is typical with all Fat transfer procedures

Boris M. Ackerman, MD · Answer

Breast enlargement with fat grafting does work, but one can not get enlargement comparable to implant augmentation. The Brava system is quite cumbersome for the patient, but it does somewhat improve the results of fat grafting to the breast. Conversely, you could choose to undergo more than one session of fat grafting, few months apart, to get the desired result. As for freezing and storing the fat for later use, it has to be done in a very specific fashion to preserve the viability of fat. This techniques is not readily available, so be beware of any surgeon readily offering this.

J. Jason Wendel, MD, FACS · Answer

The BRAVA system in not required but it allows for a larger volume of fat to be transfered during a single session by expanding the breast tissue and increasing the blood supply. This leads to a higher percentage of fat survival and more grafted fat.

	Without the BRAVA, about 150cc of fat can be transfered to each breast during a single session.

	With the BRAVA, 250-300cc of fact can be transferred to each breast during a single session.

	To be sure fat grafting is right for you, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.

	When you call, ask if the plastic surgeon is trained and experienced in fat grafting. I hope this helps.

Mahlon Kerr, MD, FACS · Answer

The Brava system helps to increase the relative breast laxity so that fat can be added with greater ease and more volume per session.  For an increase of 1-1.5 cup sizes it's probably not needed, to gain any larger increase in volume then I would reccomend it and the results will be improved.  I don't store or freeze fat and I don't know anyone who is having reliable results doing this.  Good luck!  Dr K

Hasan Ali, MBBS, MRCS, MS · Answer

Deepending on the expertise of the surgeon BRAVA can be used prior to breast augmentation. Geographically in Dubai we have limited use of BRAVA and most of my cases i will only utilize the fat grafting. 
A good surgical principle has to follow when it comes to fat grafting to the breast, good blood supply is required for the fat grafting to survive. excessive amount of grafting may not survive as there can be central necrosis in grafted fat. 1-2 session is advisable if large volume is planned.

Suzanne A. Trott, MD · Answer

The BRAVA is not available at this time, so that makes your decision easy. I have had a few patients wear it when it was available, and it is cumbersome and difficult to wear, and I am not sure that it made any difference in the amount of fat that stayed.

Robert Whitfield, MD · Answer

Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide.  These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!

Fat grafting is a valuable tool in breast surgery.  This technique has gained more popularity
over the past 7 years.  There are many
techniques used to harvest the fat, process the fat and then re-inject the fat.
Conventional suction lipectomy is performed with a small diameter cannula,
processed by separating the liquid and fibrous tissue from the fat, and then
placed into syringes for re-injection or through a closed system.

Lauren Greenberg, MD · Answer

The BRAVA system is an expansion system you place on your breasts for 4+ weeks prior to surgery and then for a few weeks after surgery.  The thought is BRAVA

	
		expands the skin envelope
	
		increases vascularity
	
		? increases growth factors and other things to help the fat
	
		keeps pressure off the newly transferred fat


	So does it work?

	A study came out by Dr. Khouri in Miami, who I worked with last summer and saw his patients firsthand.  The study was published in the May 2012 Journal of Plastic and Reconstructive surgery.  It did volumetric MRIs of patients before and 6 months after surgery showing the degree of fat survival is higher than for other studies which did not use BRAVA. For my blog on this

	I think for women who have tight skin- no kids yet, no breastfeeding, etc- they must stretch out their skin.  Otherwise there is no "space" to graft into, the pressure will kill the newly transferred fat.

Kevin Tehrani, MD, FACS · Answer

Depending of your final desired size and your current size, BRAVA is likely not neccesary. You can typically expect at least one cup size permanant increase. This is especially true if you are starting with at least a B cup.

Is Brava Necessary for Fat Transfer to Breast?

Answers (16)

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